Working together better to improve emergency operations for children

Wednesday 6th September 2017

A decision to change the way some children’s surgery and anaesthesia services are provided in South and Mid Yorkshire, Bassetlaw and North Derbyshire has been made (Wednesday 28 June 2017) by the joint committee of clinical commissioning groups.

Over the last three years, clinical commissioners and hospital trusts providing services in Barnsley, Bassetlaw, Chesterfield, Doncaster, Rotherham and Sheffield have come together to review and improve the care and experiences of all children needing an emergency operation in our region.

By working together better across all hospitals and commissioning organisations, new ways of working have been developed which means the number of children affected by these changes has reduced since the launch of the consultation in October 2016 and gives staff working in the services more opportunities to improve and enhance their skills.

Around one or two children per week needing an emergency operation for a small number of conditions, at night or at a weekend, will no longer be treated in hospitals in Barnsley, Chesterfield and Rotherham and will instead have their surgery at Doncaster Royal Infirmary, Sheffield Children’s Hospital or Pinderfield’s General Hospital where the right staff, with the right skills, will be available 24 hours a day, seven days a week.

Des Breen, consultant anaesthetist and medical director for the Working Together Partnership, said:

“As discussed throughout the 19 week consultation period, we’ve been facing a number of issues which mean that we need to change how we provide emergency out of hours operations for children across the region.

“The relatively small number of out of hours emergency operations carried out means that some staff don’t operate on as many children as others and some services don’t meet the standards we all expect to provide.

“Nationally, we don’t have enough expert staff to provide care in all hospitals, all of the time and patients in some areas are having better experiences than others. We also know that we need to change how we work now so that we don’t face more problems in the future.

“This is one of the first times we have really come together to work differently and by working this through with our doctors, we’re supporting local teams to do as many operations as possible in a planned way.

“We’ve listened to the consultation feedback and worked with expert groups of clinicians in the various specialties to identify those children who really will need an operation straight away, with no child receiving anything but the best, high quality care or being transferred unnecessarily.”

By introducing a ‘managed clinical network’ approach where staff work across organisations, a 24 hour, seven day a week emergency service will be provided for children in specialist hubs with very specially trained ambulance crews taking a child to the best place for them in terms of getting the best, most appropriate care.

Will Cleary-Gray, director of sustainability and transformation for South Yorkshire and Bassetlaw, said:

“As we’ve worked through how we can best ensure all children in our region receive the best quality, care and outcomes, the conclusion we’ve reached with our doctors is that in most cases, emergency surgery can take place in hours in all local hospitals. Thanks to an agreed networked way of working, which has come out of the review and consultation, it means only a small number of children will be transferred out of hours and on weekends.

“We are now starting to look more widely at how children who are ‘acutely ill’ are seen and treated across the region and to explore how we can improve quality, care and outcomes for them. This work is likely to see more proposals for doing things differently across the region, and therefore the out of hours surgery is the start of the journey for making improvements.

“We’re absolutely committed to having as many services as close to where people live as possible. This includes urgent care. As part of our work in South Yorkshire and Bassetlaw, we’re working with local clinics and surgeries to make this happen, and at the same time, are looking at how those services that need to be in a hospital can continue to happen in a more planned and sustainable way to offer the best care and the best services for the region as a whole.”

Please note: Children needing care and treatment for very significant injuries are already taken directly to Sheffield Children’s Hospital. It’s the only major trauma centre able to look after children in our region and this will not change. There will also be no change in Bassetlaw, where children who need an emergency operation out of hours are already taken to Doncaster.